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Going back to basics in the fight against Perio

7 August 2015

Image from the GSK Symposium held at Europerio 8

Periodontal disease certainly is one of the most prevalent diseases of our times. More than half of all adults in the UK, and 50% of the population globally will be affected by it with rates peaking in middle age. It not only causes tooth loss, but can also lead to severe medical difficulties elsewhere, including cardiovascular disease and lung infections. Dentists are on the frontline in the fight against what is, ultimately, a preventable disease and, at a recent conference, all things Perio were discussed and dissected to allow the wider dental community to understand the risks, expand their possibility of treatment and discuss how to promote effective prevention.

EuroPerio 8 was held in the Excel, London and, by all accounts, was a fantastic success. Dr Soha Dattani, Area Medical Director Great Britain & Ireland certainly enjoyed the event. She began: “This is absolutely my favourite conference. I think to have 10,000 periodontists, budding perio-lovers in one building for three days and to have every lecture theatre full right from 8.45 in the morning to 6 in the evening just says it all.”

Among the many positive aspects of the conference, there was one, in particular, that Dr Dattani welcomed. “What I love about this is that it’s going back to the patient,” she explained. Mentioning the screening of a movie entitled “The Sound of Perio”, Dr Dattani said it emphasised something which can often get lost in all of these Perio discussions: the patient.

She went on: “It was about how periodontal disease can have systemic effects on gastrointestinal disease and diabetes but Sound of Perio went back to the basics of making it all about the patients because, often, we can get caught up in the “new surgical technique” or the “new laser wizardry”, and forget that ultimately we’re here to help the patient.”

This patient focus is something she has brought to her latest role within GSK as medical director for the UK and Ireland, which is a little surprising given her background. Originally trained as a specialist periodontist, she made the move into medical affairs and marketing at GlaxoSmithKline over a decade ago. She explained: “In my career as a dentist I may be able to treat maybe a thousand, maybe ten thousand, patients depending on how long I stayed in my career. But, ultimately, if I could work within a company and help to develop products, I could potentially help millions of patients around the world.”

Her role meant that EuroPerio presented a unique opportunity to bring things back to basics and put patients back to the very heart of periodontics, something that is very important given the chronic prevalence of the disease. “Data from the 11th workshop that they recently presented was that actually it’s the sixth most burdensome disease that affects humans, so it’s huge. But unlike so many other things it is preventable.” Dr Dattani even admitted to a few eye-openers which would have wrong footed many clinicians, such as the message of brushing for two minutes translating to an average of 47 seconds for the majority of people.

Controlling the key risk of the disease, super-gingival biofilm present at the gingival margin, is important but Dr Dattani sees GSK as having a crucial role to play in the promotion of good oral health with the both the profession and the general public. In regards to the profession, she sees a role for the global healthcare company in providing a joined up approach that will really benefit the public. “Together, we can help to educate and manage patients in terms of their understanding about the importance of early diagnosis and potential signs and symptoms that should make them, first, go to the dentist to understand that something’s wrong and then to put a maintenance plan in place that’s actually going to be achieved and followed by them,” according to Dr Dattani.

As well as that, the wide audience that such a large company would gather is used in an effective way to drive home, sometimes tough, messages. Referencing one advert for Corsodyl, in particular, she said: “The advertising is all about disrupting patients’ behaviour so they notice that spitting blood when they brush, which is often ignored, has a long term consequence. If there was blood coming from any other part of your body, you would go and see a medical practitioner. But there’s something about the oral cavity that we’ve almost accepted that bleeding is acceptable or we’re scared of the consequences so we don’t go and see our dental professional.”

“So I think it’s really important that, as a company, it’s our job to drive patients, as consumers, to the dental professional at that early sign.”

Speaking about how the dental professional can then treat patients effectively and prevent perio at its source, Dr Dattani is delighted with the work GSK has done to educate the next generation of dentists on the most effective, efficient methods as well as incorporating the patient into the equation. 95% of professionals believe that managing gingivitis is important to oral health, with 53% agreeing that giving oral hygiene advice significantly reduces rates. Around 40% of dental professionals would recommend using a mouthwash/antiseptic to help manage gingivitis, whilst 53% recommend using a chlorhexidine product for treatment. “I’m really proud of the work GSK has done,” she explains. “Bringing digital technology to the dental practitioner in an easy way… The way students now learn, the way younger pupils learn, not like I do from a book, they learn from digital stuff. So we’ve created an app that’s almost just as a reminder for them. It’s more about images you can share with your patients to say ‘this is why I’m doing this’.”

Practicalities are crucial, and she believes the example set by the aging population in Japan is one that the UK should really take on board. “Japan is where we will be in 15 years’ time in terms of their aging population is there now,” she explained. “And there within their dental schools, they’re teaching their students such that patients probably, a vast majority of them won’t be coming to see you, you’ll be going to see them.

“You know, they’re [patients] living longer, but they’re retaining their teeth for longer. But at some point your manual coordination and dexterity is not such that you can do everything. So therefore doing all this funky implant work, this crown and bridge work, you’ve got to be doing it with the thought that when the person is 70 they might be able to do the superflossing or the interdental cleaning but actually how are they going to that when they’re 80, how are they going to that when they’re 90?”

We conclude the discussion on the symposium that GSK had planned for later on that evening. The symposium based itself on the simple premise of “Is it preventable?” “It’s not controversial but it’s something we don’t talk about,” according to Dr Dattani. It’s about challenging the form of unsaid acceptance that people don’t brush for two minutes twice daily, and that they don’t follow their directions regarding interdental cleaning. She concluded: “As a company, we’ve got a range of solutions that fit perfectly into this, from the toothpaste to the daily mouthwash… But it’s not about product, it’s about preventing a disease that affects 50% of the population, and affects something that’s so important to everyone: their smile!”